NPI | 1679068290 |
---|---|
Entity Type | Organization |
Authorized Contact | BRITTANY GRADY General Dentist/Practice Owner 317-418-7511 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 31446) |
Enumeration Date | 2018-06-26 |
Last Update Date | 2018-06-26 |